The Obamas Don’t Diet and Neither Should You “It’s a Lifestyle”

My heart is full at this very moment. It’s not often that positive messages about healthy living get out there. It’s RARE that the word “DIET” is out there in a negative or neutral context. But that’s exactly what happens in this video with Sam Kass, White House Chef when he said “we don’t diet – it’s a lifestyle”. THANK YOU! It is so important for the public to hear dieting in a negative context.

People equate healthy living to dieting. That is not the case. Changing your behaviors to eat more nutritious may feel like “dieting” because it is so new, but when you eat healthy, nourishing foods your body will naturally lose weight if you need to. People also equate “not dieting” to eating without any boundaries, inhibitions, or structure. Also not the case. Intuitive eating guides you to balance out what your body needs (nourishment) and wants (cravings and appetite)

Dieting is deprivation and a complete waste of time. If you need motivation for swapping a diet-mind for a self-care mind focused on your own health (not size) check out the “me” movement. However, we have a long way to go… check out some of the post comments in the Yahoo blog. People ripped apart the use of dried fruit. Hello, FOOD POLICE. Thankfully others in the comments sorted it out. It is so clear that most of us are still very diet-minded. It’s another reason we have to ditch diets!

Yahoo video: A favorite Michelle Obama snack: Exclusive access into White House kitchen

Fruit, Nut and Oatmeal Bars

originally posted at Yahoo.

Ingredients:

6 tablespoons grapeseed oil, or other neutral oil, plus extra for brushing pan
2 cups rolled oats
½ cup mixed seeds, such as pumpkin, sunflower and sesame
½ cup honey
½ cup dark brown sugar
1/3 cup maple syrup
Pinch of salt
1 ½ cups mixed dried fruit, such as raisins, cherries, apricots, papaya, pineapple and cranberries (at least 3 kinds, cut into small pieces if large)
1 teaspoon ground cardamom or cinnamon
2 tablespoons of butter

Directions:
1. Heat oven to 350 degrees. Line a 9-inch-square baking pan with parchment paper or foil, letting a few inches hangs over side of pan. Brush with oil
2. Spread oats and seeds on another baking pan and toast in oven just until golden and fragrant, 6 to 8 minutes, shaking pan once.
3. In a saucepan, combine oil, butter, honey, brown sugar, maple syrup and salt. Stir over medium heat until smooth and hot. In a mixing bowl, toss together toasted oats and seeds, dried fruit and cardamom. Pour hot sugar mixture over and stir until well combined.
4. While mixture is warm, transfer to prepared pan, pressing into pan evenly with an offset spatula.
5. Bake until brown, 25 to 30 minutes. Transfer pan to a rack and let cool completely. Using the overhanging foil or paper, lift out of pan and place on a work surface Cut into bars, about 1 ½ inches by 3 inches.

2010 Dietary Guidelines Summary Released!

It’s big news for nutrition. We may have new advice for eating healthy… and you can give your 2 cents, if you feel so inclined. Every five years the Dietary Guidelines for Americans are updated to reflect the latest knowledge in science and research. The Guidelines are used for government nutrition initiatives, programs and education, as well as by dietitians and health professionals to help educate people about eating healthier.

Dietary Guidelines (DG) Advisory Committee released their Executive summary on Tuesday, June 15th, 2010. The full report can be found here and is currently open for public comments. (that’s you, the public…let your voice be heard and comment on the Executive Summary).

The Committee has used a state-of-the-art, web-based electronic system and methodology, known as the Nutrition Evidence Library, to answer the majority of the scientific questions it posed, about specific nutrients and foods.

What’s New in 2010?

The 2010 Guidelines are different from previous reports in that this one addresses an American public of whom the majority are overweight or obese and yet under-nourished in several key nutrients. (It may sound strange, but it is possible to be overweight and under nourished at the same time.)

This DG also focuses more on children because primary prevention of obesity must begin in childhood. They say this is the single most powerful public health approach to combating and reversing America’s obesity epidemic over the long term.
To reduce the incidence of overweight and obesity in our country they recommend that we:

• Shift food intake patterns to a more plant-based diet that emphasizes vegetables, cooked dry beans and peas, fruits, whole grains, nuts, and seeds. In addition, increase the intake of seafood and fat-free and low-fat milk and milk products and consume only moderate amounts of lean meats, poultry, and eggs.
• Significantly reduce intake of foods containing added sugars and solid fats because these dietary components contribute excess calories and few, if any, nutrients. In addition, reduce sodium intake and intake of refined grains.Daily sodium intake be 1,500 mg, (down from 2,300mg in the 2005 recommendations).
• Eliminate Trans-fatty acids from the diet, and seeking to increase the amount of omega-3 fatty acids in diet.
• Increase physical activity: adults should get at least 2½ hours of moderate-intensity physical activity each week, such as brisk walking, or 1¼ hours of a vigorous-intensity activity, such as jogging or swimming laps, or a combination of the two types. Kids and teens should do an hour or more of moderate-intensity to vigorous physical activity each day.

While I strongly support these recommendations, there are several things that must be changed about our  Food environment so that eating healthy is easy, accessible and affordable. Hopefully our government will launch initiatives that seek to improve the following points:

• Improve nutrition literacy and cooking skills, including safe food handling skills, and empower and motivate the population, especially families with children, to prepare and consume healthy foods at home.
• Increase comprehensive health, nutrition, and physical education programs and curricula in US schools and preschools, including food preparation, food safety, cooking, and physical education classes and improved quality of recess.
• For all Americans, especially those with low income, create greater financial incentives to purchase, prepare, and consume vegetables and fruit, whole grains, seafood, fat-free and low-fat milk and milk products, lean meats, and other healthy foods.
• Improve the availability of affordable fresh produce through greater access to grocery stores, produce trucks, and farmers’ markets.
• Increase environmentally sustainable production of vegetables, fruits, and fiber-rich whole grains.
• Encourage restaurants and the food industry to offer health-promoting foods that are low in sodium; limited in added sugars, refined grains, and solid fats; and served in smaller portions.

With over two thirds of our population either overweight or obese, this has a huge impact on the healthcare system, and our entire nation. On average, Americans of all ages consume too few vegetables, fruits, high-fiber whole grains, low-fat milk and milk products, and seafood and they eat too much added sugars, solid fats, refined grains, and sodium. Added Sugar and Fat contribute approximately 35 percent of calories to the American diet. (these are just empty calories) The current US Food environment is loaded with excess sodium, sugar, fat and refined grains, making it harder for the average consumer to eat healthy. We have to seek out healthy foods and do some detective work when eating out.

This summary is now open for public comments-so what do you have to say? Tell me here or submit your comment to the committee here! You can also read what others are saying here. Will changing the recommendations help make American healthier or do we first need to change the entire food environment?

Food Inside The Obama White House

I was watching NBC’s Special Inside the Obama White House. I have to take pride in that my husband was on the production team making it happen.

Of course, the food expert in me has to find my personal interest hook – the food! So here’s a play-by-play of what was covered.

Apples by the basketfull! Obama wants to encourage healthy snacking by making apples available on hand in nearly every room. Apples have natural sugars – carbohydrates for quick energy, fiber for fullness, and even some vitamin C to keep the immune system supported. All this for under 100 calories!

M&M’s – Is it any surprise that there would be candy too? M&M’s are the perfect tiny piece of chocolate Americana you’d expect to see on hand for staffers to nosh on.

Also a favorite of staffers is nuts! There was a huge container of Planters mixed nuts on one of the office tables. With enough protein and fat to crush any hunger pains, one handful of these suckers can easily tide staffers over until the lunch meal.

Speaking of lunch, how does a greasy burger and fries sound? Obama made an unannounced trip to Five Guys and picked up lunch for the whole crew. What’s a cheeseburger and 1/2 order of fries going to set you back? How’s about 900 calories and 50 grams of fat sound?!

Lest you think the Obama’s are headed for obesity, don’t forget it was a special occassion with 27 NBC crews visiting. Most other meals of the week start with a walk through the Obama White House garden and of course an endless supply of nature’s bounty whipped into delicious meals by the expert chefs.

What do you think about the food highlights in the first NBC segment?

Are Presidential Candidates Responding Enough to Healthcare Woes?

There’s an interesting editorial in the Chicago Tribune today.The authors challenge the candidates solutions for fixing health care, asserting that although they have presented platforms, they haven’t addressed real issues, such as why healthcare is so expensive. (excerpt below, full article here)

Some days Mack MacQuarrie defies his Type 2 diabetes and submits to the temptations of a ballgame hot dog. Some days his legs swell, fluid fills his stomach and chokes his breathing, and he finds himself in the emergency room. He knows he should manage his disease better, but very little in America’s health-care system encourages him to do so.

(Rebecca’s note: I don’t think this guy is just eating a hot dog and landing in the hospital. With type 2 diabetes, you can have a hot dog (if you want to…) The carbs are in the hot dog bun and as long as he stayed away from other carbs – soda, fries, ice cream, pretzels, cracker jacks etc. – he can have the dog. OK, back to the story).

MacQuarrie’s doctors get paid to drain the 2 gallons of fluid from his purple-bruised legs, but not to call to ask about warning signs. His insurance covers the hospital stays, even when he skips doctor’s visits because, as he says, “the co-pays tear you up.” And so he often lands here, at Henry Ford Hospital, running up medical bills as high as his blood sugar count.

Polls show voters worry a lot about health care and how much they spend on it. Presidential candidates John McCain and Barack Obama have responded by peddling plans they claim will help more Americans attain and afford care.

But neither candidate has focused publicly on treating the real problem: why American medical care costs too much and isn’t as good as it should be.

I agree with the article authors on some points, but I think their arguments would have been strengthened by bringing the importance of chronic disease prevention to the forefront. Their arguments (below) are really costs that occur once a person is already sick. Yes, let’s deal with it… but we are missing the boat on huge costs savings if we don’t acknowledge the need for prevention to be front and center of health care.

We waste money on tests and visits to specialists that don’t make us better. We spend big to add a few weeks or months to the inevitable end of a dying patient’s life. We use expensive technology at any cost, even when it exceeds our needs, and we fail to encourage simple, proactive steps that would keep us healthier and save us money. We often don’t know which treatments work the best, so we err on the side of too much care, for too much cost, with sometimes damaging consequences.

The reality is that chronic disease management eats up huge dollars, but many chronic diseases can be prevented through weight management – obesity, diabetes, heart disease, hypertension, many cancers… and the list goes on. I know my readers have heard this before from me, but I will say it once again. Health care needs to wake up and pay for disease prevention services – and they should start with visits to a registered dietitian. Bottom line: health behaviors such as diet and exercise are critical for weight management. Preventing further weight gain in overweight people can help prevent weight-related chronic diseases. Establishing healthy eating patterns with families or individuals can make a world of difference. Weight management is one thing, but since you truly are what you eat, people will also feel more energy, and less stress, which contribute to their well-being and overall health. Yet, in order for a “healthy” person to see a dietitian, they have to be prepared to pay a pretty penny because visits to a dietitian are not covered.

This makes no sense. Think about it. We spend most of our lives looking or feeling healthy for the most part. We pay huge amounts each month in “health care”, but we don’t receive any. Why would someone feel they “should” pay out of pocket for health care services a registered dietitian provides? They already feel like they are paying too much. So many dietitians avoid going in to private practice because they know they will have to struggle with insurance companies and/or fight this battle of convincing people who already pay for health care that they need to pay more out of pocket.

Why can’t insurance pay for an annual nutrition checkup – a nutrition assessment and a couple follow up visits with a registered dietitian? If nutrition diagnoses are found, insurance companies can decide what follow ups to pay for based on the diagnoses or they can cover a percentage of follow ups. The point is, something is better than nothing and consumers get nothing when it comes to nutrition services. But by providing these assessments, we can detect problems earlier and deal with them before they become bigger and more expensive issues.

Back to the editorial… I will say this… the authors got Obama wrong. He has presented a case for disease prevention, including paying for registered dietitians for disease management and his plan for obesity goes way beyond advertising to kids (which seems to be the focus). He want to improve the wellness environment by making changes to the schools and communities where people are. Check out a couple past posts for more info.

http://rebeccascritchfield.wordpress.com/2008/09/03/obama-on-obesity/

http://rebeccascritchfield.wordpress.com/2008/02/05/senator-obama-sees-registered-dietitians-as-a-valuable-resource-to-improve-health-care/

What are your thoughts on health care? Where do we need to go?

Obama on Obesity

Last week Advertising Age suggested that Presidential Candidate Barack Obama might be taking a softer approach on childhood obesity because his senior director of domestic policy, Melody Barnes, said the campaign did not discuss restrictions on marketing and advertsing of “junk food” or upping the ante on federal advertising to promote healthy behaviors as tactics for addressing obesity.

For the life of me, I don’t understand why Advertising Age would perceive Obama’s strategy as a softer approach. The strategy is anything BUT soft. Here’s an excerpt on the plan:

Melody Barnes instead suggested that an Obama administration would take a holistic approach toward childhood obesity that includes the possibility of greater federal funding for physical education, new programs to encourage health insurance companies to pay for preventative health care, more education about food choices and better school menus.

Why would Obama make advertising regulation an integral part of the plan when it is well-known that it is behavior that matters more? How far would regulation “move the needle” on obesity compared to these other tactics? The industry is already down a path of self-regulation, with the Children’s Food and Beverage Advertising Initiative. So, until the research evidence demontrates that self-regulation doesn’t work, what would more federal regulation do?  Certainly the idea of increasing federal regulation is nothing new, which  contradicts Obama’s “Change” campaign anyway.

But I’ll tell you what IS new… increasing federal funding for physical education at a time when budget constraints result in schools cutting phys ed. Programs for insurance to cover preventative health care is also a new approach, considering that today registered dietitians cannot get reimbursed for counseling an overweight person to help them prevent obesity unless they already have diabetes or kidney disease — and the number of visits allowed is miniscule at 2 per year.

Through all the twists and turns of legislative advocacy that champion MNT benefits for Medicare beneficiaries, the way it stands today is that Medicare Part B covers MNT when it is ordered by a physician for people with kidney disease (who aren’t on dialysis), have a kidney transplant, or have diabetes. These services can be provided by an RD or Medicare-approved nutrition professional and may include nutritional assessment and counseling. Medicare recognizes a nutrition professional as a qualified dietitian, licensed RD, licensed nutritionist that meets the RD requirement, or grandfathered nutritionist who was licensed as of December 12, 2000.

View full article

If we are going to provide nutrition care to people with insurance who may not be able to afford 100% percent of the costs for RD visits out-of-pocket then we need to reimburse the dietitians for their health care services. They are the nutrition experts and nutrition is key to preventing obesity and maintaining a healthy weight.

More education about food choices is also a smart strategy. Yes, yes, yes… consumers know that fast food and most processed food is not health food. But the recent laws on menu labeling in NYC have shown that even health-conscious people are shocked to find out the actual fat and calories in bakery muffins and restaurant salads. From my own experiences working with people of various ages, races, and income levels knowledge of basic nutrition, like calorie needs and balancing healthy meals, was lacking across the board.

Who could argue against the notion that school lunches can be improved? Competition from other foods of little nutrition value and unappetizing options in general means we are setting our kids up for a lifetime of poor food preferences.

No, I don’t think these changes reflect a soft approach to tackling obesity in America. Rather, it appears that finally some strategies we can hold on to are in the works. Regulation of tv commercial may have its place in the obesity landscape. But I’d rather bet on active kids making healthy food choices due to better education and access to weight-related health care as ideal catalysts for behavior change.

Senator Obama Sees Registered Dietitians as a Valuable Resource to Improve Health Care

Well, it’s about time… prevention in health care may stand a chance after all. Senator Obama highlighted the importance of dietitians to help save precious health care dollars in the democratic debates last week.

So I’ve already said a sizable portion of my health care plan will be paid for because we emphasize savings. We invest in prevention. So that, you know, as I said before, the chronically ill, that account for 20 ppercent — or the 20 percent of chronically ill patients that account for 80 percent of the cost — that they’re getting better treatment. We are actually paying for a dietician for people to lose weight, as opposed to paying for the $30,000 foot amputation. That will save us money.

Visit the transcript page 

I am sure dietitians around the globe would join me in saying that this is huge for the entire field of dietetics and health care.  You see, dietitians have strong expertise in food and nutrition. They have the knowledge and skills to help people who want to change nutrition-related behaviors to manage diseases — and maybe even prevent disease from even happening in the first place. But the right health care system needs to be in place to enable dietitians to provide their services before conditions get too serious. Reimbursement is a huge problem. Unless you have end-stage renal disease or diabetes you will have a hard time getting insurance companies to help pay. In his quote, Obama was referring to costly amputations that result from diabetes that is not well-managed. Dietitians can provide medical nutrition therapy to help people lose weight over time, bring their diabetes under control, and prevent complications. (I’m sure everyone with diabetes would like to keep their feet if possible.) Dietitians have been under-utilized for far too long. It’s high time dietitians are recognized for their unique contributions and are better positioned to help improve health care.